Office of Workers' Compensation Programs Needs To Improve Procedures To Help Reduce Payment Errors and Identify Dual Payments

GAO completed a survey of payment and collection activities administered by the Office of Workers' Compensation Programs (OWCP).

GAO found that incorrect payments were made in about 20 percent of the payment transactions reviewed, and about 5 percent of the benefits paid during the test period were incorrect. Most errors occurred because claims examiners and other personnel did not process, incorrectly processed, or failed to follow up on data in case files. More than half of the transactions which involved errors had been reviewed by supervisors who did not detect the errors. In addition, local quality control units were not required to, and generally did not, review the accuracy of the payments. GAO found that these problems were not identified by OWCP because its quality control procedures were not adequate. In addition, some beneficiaries were overpaid because they improperly received Civil Service retirement benefits at the same time they were receiving workers' compensation benefits. These dual payment errors could have been avoided by annually questioning beneficiaries on retirement benefits received and comparing its benefit roll to that of the Office of Personnel Management (OPM). GAO also found that claims examiners had not followed debt collection procedures for almost two-thirds of the accounts receivable cases tested.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Franklin A. Curtis Team: General Accounting Office: Human Resources Division Phone: (202) 275-5451